B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid CarcinomaReport as inadecuate




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International Journal of EndocrinologyVolume 2013 2013, Article ID 203610, 7 pages

Clinical Study

Department of Health Science, Chair of Radiology, University of Molise, Contrada Tappino, 86100 Campobasso, Italy

Department of Medicine and Surgery, the University of Salerno IT, Italy

Received 20 December 2012; Accepted 26 April 2013

Academic Editor: Annabel E. Barber

Copyright © 2013 Giuseppina Napolitano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Papillary thyroid cancer PTC is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes LNs. The ultrasonography US is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging BFI, recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs BFI-TS, within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high values ​​of specificity 99.7% and sensitivity 80.9%. The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.





Author: Giuseppina Napolitano, Antonio Romeo, Andrea Bianco, Maurizio Gasperi, Pio Zeppa, and Luca Brunese

Source: https://www.hindawi.com/



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